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8.05: Zone N3 – Distal Nose

YOUR ASSIGNMENT FOR THIS LESSON

✅ Step #1: Review all content below.

✅ Step #2: Image the N3 zone on your own with your ultrasond, and using the checklist provided on this page, check off all key structures to be identified in this location

TRANSDUCER POSITION AT N3

STANDARD N3 ORIENTATION:
TRANSVERSE

The most disal tip of the nose is the location of N3.

QUICK TIP
  • Like in other areas of the nose, use lots of gel to compensate for the contour and rounded shape of the structure being imaged.
  • Compared to other areas of the nose, the layers you will see here on ultrasound are relatively simple. Essentially, it is epidermis/dermis, sometimes a bit of fat, and then cartilage.

EXAMPLE OF TRANSVERSE IMAGE ACQUIRED AT N3

Standard image acquired at N3. (Transverse| Left side is patient's right). See key below for lables.*

ANATOMICAL LEGEND FOR N3 LOCATION IN TRANSVERSE

*Standard image acquired at N3 labeled with key anatomical structures. Note the sides of the image where there are horizontal lines cooresponds to ultrasound gel.

DOPPLER IMAGES ACQUIRED AT N3 OF KEY VESSELS

Play Video
QUICK TIP
  • N3's vessels are often small with slower flow. Power doppler can be useful here, also if using color doppler turn your sensitivity to 2cm/s to detect the slower flow. Just be mindful of motion artifacts.
  • You need to keep pressure off the nose; otherwise, you will easily occlude these vessels. Again, use lots of gel and a very light touch. Pressure should be applied to the gel, not directly to the skin.
  • This is an area where a network of vessels is anastomosing. So, the exact pattern of Doppler flow will differ in this location from patient to patient. 

DO IT YOURSELF CHECKLIST

Structures to Identify on Ultrasound for N3

Once you have completed this checklist, mark this part of the lesson as complete.